Provider Demographics
NPI:1841545183
Name:SWAFFORD, SARAH (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SWAFFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 351
Mailing Address - Street 2:
Mailing Address - City:VARNELL
Mailing Address - State:GA
Mailing Address - Zip Code:30756-0351
Mailing Address - Country:US
Mailing Address - Phone:706-460-2170
Mailing Address - Fax:706-971-1598
Practice Address - Street 1:5399 CLEVELAND HWY
Practice Address - Street 2:
Practice Address - City:COHUTTA
Practice Address - State:GA
Practice Address - Zip Code:30710-9509
Practice Address - Country:US
Practice Address - Phone:706-460-2170
Practice Address - Fax:706-971-1598
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL347952084P0800X
GA0805152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA080515OtherLICENSE